My First Experience with Hepatitis C as a Healthcare Professional
Pharmacists spend their training learning about the details of every condition, from its diagnosis to treatment. As a student, it can be difficult to grasp the effect of hepatitis C on people's lives. Many pharmacists do not have direct experience helping people manage hepatitis C in practice. I recall the first customer I met at the pharmacy who knowingly had hepatitis C...
Point-of-care testing at the pharmacy
It was during a new initiative which involved pharmacists administering hepatitis C point-of-care tests. This is a finger-prick test that detects antibodies to the hepatitis C virus. The test does not confirm the diagnosis of the virus, because the presence of antibodies alone does indicate whether the virus is acute, chronic, or has been spontaneously cleared. The goal of the initiative is to help minimize barriers to testing.
Prior to the testing, each customer fills out a form. It asks about the individual’s risk factors, demographics, and whether they have been treated for hepatitis C before. The purpose of the form is to collect data on who receives testing. The test is not funded publicly, meaning that customers have to pay out-of-pocket for the test.
My first customer
The first customer who came into the pharmacy requesting a test answered no to the risk factor questions, including the question asking whether he had been treated for hepatitis C before. He told me that he heard about the testing on the news and wanted to be tested because of his symptoms of fatigue. He divulged his real name, which for the purpose of the testing, he wasn’t required to.
As I was opening up his file to process the test, a history of all his most recent medications popped up on the screen. A drug on his file from a few months ago caught my eye: it is a drug used to treat hepatitis C. I was conflicted on how to handle the situation. It appeared that he had been treated, but he did not want me to know. On the other hand, because this test was an antibody test and not a confirmatory one, the result would be reactive. This is because the antibodies to the virus never go away.
I asked him whether he has been treated for hepatitis C before. He said yes. I told him that I can go ahead with the test if he would like, but we know what the result will be. I explained to him why the test will show reactive to antibodies. It turned out that he just wanted to know whether he cleared the virus. We concluded that it would be best that he follows up with his specialist. This way, he can receive a lab requisition to confirm the success of his previous treatment.
We're here to help!
That day was my first experience of the reality of those living with hepatitis C, specifically the fear of stigma. Divulging your hepatitis C diagnosis with your pharmacist is not mandatory. It’s hard, and some healthcare professionals will not understand exactly how you feel. But we care, and we want to be able to help in any way we can.
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